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Introduction: Early identification of developmental dysplasia of the hip (DDH) is necessary to minimize its negative effects. Ultrasound screening is useful for detecting DDH in hospitals. Awareness about community-based screening systems is low in Japan. Despite established nationwide home visiting services and child health checkups in the country, more than 10% of DDH patients are diagnosed at the age of ≥1 year. This review aimed to clarify the status of universal ultrasound screening for DDH among infants in community settings in Japan. Methods: The electronic databases of Igaku Chuo Zasshi, MEDLINE, CHINAL, ERIC, and APA PsycInfo were searched for articles published between 2002 and 2022. Articles were evaluated with the reach, effectiveness, adoption, implementation, and maintenance framework. Results: In total, 148 articles were identified. Two articles were manually added, and 67 articles were excluded through abstract reviews, of which 20 were duplicates. Finally, 18 articles were included in the analysis. There are two types of universal ultrasound screening in community settings: municipality-led and hospital-led. Since 1992, municipality-led screening has been conducted during public infant health checkups in five municipalities. Six hospitals implemented ultrasound screening. The participation rate was around 90%. The Graf method is typically used for this purpose. The prevalence of abnormal hips was 3.6%-16.6%. Owing to limited human resources and skills in ultrasound, all studies mentioned the necessity of a universal screening system for the early detection of DDH. Conclusion: Embedding universal ultrasound screening in community health checkup systems enables collaboration between healthcare professionals and caregivers to improve health inequities and ensure early detection of DDH cases.
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Background: While suboptimal medication adherence remains an obstacle to the management of hypertension and diabetes in China, few studies have investigated associated factors with medication adherence on different dimensions simultaneously. Objective: To systematically examine associated patient, family, and community factors with suboptimal medication adherence among people with hypertension and/or type 2 diabetes in China. Methods: The study stratified a random sample of 622 adults aged 45 years or older with hypertension and/or type 2 diabetes from three southeast cities in China in 2019. Trained interviewers used the Morisky Green Levine Medication Adherence Scale, Self-Efficacy to Manage Chronic Disease (SEMCD) Scale, and the Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) Scale to assess medication adherence, self-efficacy, and family function, respectively. Participants also reported their perceived satisfaction with community health services (quantity, quality, affordability, and overall acceptance). The study used the multivariable logistic regression to assess the association of patient, family, and community factors with suboptimal medication adherence. Results: Among the participants, 42.9% reported suboptimal medication adherence. In the multivariable logistic regression model, male participants (odds ratio [OR] = 0.55, p = 0.001) had higher medication adherence compared to females. Having a self-efficacy score that was lower than or equal to the sample mean was significantly associated with lower adherence (OR = 1.44, p = 0.039). Participants unsatisfied with the affordability of community health services and medicine had lower adherence (OR = 2.18, p = 0.028) than those neutral or satisfied. There were no significant associations between family function and medication adherence. Conclusions: Sex, self-efficacy, and perceived affordability of community health services were important factors associated with medication adherence. Healthcare professionals are recommended to consider multiple factors and leverage services and resources in community health centers when promoting medication adherence.
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BACKGROUND: In home-based long-term care, care management aims to facilitate the independence of community-dwelling older adults and mitigate the escalation of their care needs. We examined the association between the types of care management (advanced vs. conventional) and the progression of care needs among recipients with moderate care needs and compared care services offered in care plans between care management types. METHODS: A retrospective, population-based observational study was conducted in Tsukuba City in Japan. The individual-level secondary data from the suburban municipal government was collected between May 2015 and March 2019. The primary outcome was the progression of care-need levels certificated in Japanese long-term care insurance. The exposure variable was advanced care management. First, we conducted propensity-score matching to adjust for differences in recipient characteristics. Second, we performed Kaplan-Meier survival analyses and log-rank tests, with the outcome measure being the progression of care-need levels. Third, Pearson's chi-square tests were performed to compare care services for recipients of advanced vs. conventional care management. RESULTS: Of the 1010 long-term care recipients, we selected 856 propensity score-matched recipients receiving advanced or conventional care management. The proportions of four-year cumulative progression-free survival in the groups receiving advanced and conventional care management were 82.2â¯% and 78.5â¯%, respectively (pâ¯=â¯.69). The proportions of the groups with advanced and conventional care management were 17.1â¯% and 23.8â¯% using home-help services (pâ¯<â¯.05), and 4.0â¯% and 8.2â¯% using community-based day care services (pâ¯<â¯.05), respectively. CONCLUSIONS: Advanced care management in home-based long-term care was not associated with a slowing of the progression of care needs among older adults with moderate care needs compared with conventional care management. There was a notable discrepancy in the use of care services, with the advanced care management group having lower rates of use of home-help services and community-based day care services compared with the conventional care management group.
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Background: Restorative justice interventions can help address the harm created by gun violence, although few restorative justice programs focus solely on survivors or loved ones of victims of gun violence. Our aim was to assess how gun violence impacts those injured by firearms through qualitative analysis of their lived experiences. Methods: From August 2022 to October 2023, we operated a program entitled Prescriptions for Repair in Durham, North Carolina, USA, which was supported by community groups, public government, and academia. Through a series of structured listening sessions using a restorative justice framework, trained community-based facilitators helped 30 participants (11 survivors of gun violence and 19 loved ones of victims of gun violence) tell their stories through a non-judgmental narrative process. We conducted a qualitative thematic analysis of the listening sessions from 19 participants to define the major lessons learned from survivors of gun violence. We summarized participant responses into individual-level and community-level views on how to 'make things as right as possible'. Results: The lived experiences of gun violence survivors and their loved ones confirmed the inherent value of structured listening programs, how poverty, race and racism impact gun violence, and the need to focus resources on children and youth. Conclusions: Listening to the survivors of gun violence through restorative justice programs can help address the personal and community harm resulting from gun violence. Level of evidence: Level IV, prospective observational study.
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BACKGROUND: Real-world research on cancer care in the community should address social determinants of health (SDOH) to advance health equity in cancer diagnosis, treatment, and survivorship. We sought patient and stakeholder perspectives to co-develop research principles to guide researchers when using patient record data to address health equity in their research protocols. MATERIALS AND METHODS: Key informant interviews with 13 individuals elicited perspectives and insights related to health equity and SDOH when conducting research using data from community-based oncology care. Interviews included a brief overview of a prior scoping review and related questions in the interview guide. Key informants included experts in health equity and SDOH, and patient and community advisory board members. Rapid qualitative analysis was used to identify key themes, patterns, and insights from the interview data. Principles were developed based on the results of the analysis. RESULTS: Three overarching categories for promoting health equity were (1) education; (2) community engagement; and (3) research design and implementation. Education principles highlight the necessity of training in relevant skills to address health equity. Community engagement principles highlight various actions that researchers can take to conduct research inclusive of community concerns regarding health equity. The research design and implementation category provides practical guidelines for researchers in planning, conducting, and disseminating community-based oncology research to address health equity. CONCLUSION: Our principles guide oncology real-world research protocols to address SDOH in community settings and promote health equity. These principles should be tailored to specific cancer topics and communities.
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Background: People from rural communities are not spared from COVID-19. But implementing preventive measures and strategies can be made to control the spread. Objective: This study was conducted to describe the epidemiologic situation and the healthcare capacity of the locality, determine the responses and strategies implemented in the control of COVID-19, and explain the activities performed in relation to the epidemiologic situation in Tarangnan, Samar - a low-income class municipality in the Philippines. Methods: A mixed qualitative-quantitative design was employed in this study. Descriptive documentary research design through review of records from March to October 2020 was utilized. For the qualitative context, a case study design was employed whereby focus group discussions and key informant interviews using open-ended questions were performed. Results: A total of 66 individuals were recorded as having COVID-19 in the municipality from March to October 2020. The first recorded confirmed cases of COVID-19 in Eastern Visayas were two adults in Tarangnan, Samar, in March 2020. Since then, additional confirmed cases have been recorded every month, but confirmed COVID-19 dramatically reduced from August to October 2020. Qualitative analysis revealed stringent COVID-19 preventive measures reflected in the confirmed case numbers. The tailwinds of the COVID-19 response include: the SARS pandemic precedent, coordination and communication, outpouring of support from other government and non-government partners, and innovative community-based approaches. The headwinds of COVID-19 response were challenges in imposing minimum health and safety precautions, stigmatization, and discrimination. Conclusion: Even if challenges have arisen in implementing measures against the spread of the disease, good outcomes have been achieved through persistent good practice, positive modifications, and community-based innovations.
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This study aims to assess the service quality and user satisfaction of a community support program (CSP) in a specific administrative region of Taiwan. Employing a cross-sectional design, data were collected from 450 CSP users in the region via a questionnaire. Statistical analyses, including descriptive analysis, ANOVA, and Scheffe's Test, were conducted using SPSS 22.0. The findings reveal that users aged 70-79 years with primary education, as well as those with demand or unknown demand for long-term care, reported the highest level of satisfaction with CSP services (mean = 4.5, SD = 0.7, p < 0.05). The study underscores the influence of user characteristics and their understanding of the services on satisfaction levels. These insights provide clear direction for policymakers in shaping the future of CSPs, emphasizing the importance of addressing user needs and enhancing awareness and the utilization of available services.
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BACKGROUND: Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according to these principles is becoming more common, nurses base their actions too much on traditions and intuition. Therefore, to promote EBP in nursing practice and improve related education, more insight into nurses' needs is necessary to overcome existing EBP barriers. OBJECTIVE: To identify the current needs to work with EBP principles among hospital and community care nurses and student nurses. DESIGN: A qualitative, exploratory approach with focus group discussions. METHODS: Data was collected between February and December 2020 through 5 focus group discussions with 25 nurses and student nurses from a hospital, a community care organisation, and nursing education schools (bachelor and vocational). Data were analysed using reflexive thematic analysis, and the main themes were synchronised to the seven domains from the Tailored Implementation for Chronic Diseases (TICD) checklist. RESULTS: Nurses and student nurses experience EBP as complex and require more EBP knowledge and reliable, ready-to-use evidence. They wanted to be facilitated in access to evidence, the opportunity to share insights with colleagues and more time to work on EBP. The fulfilment of these needs serves to enhance motivation to engage with evidence-based practice (EBP), facilitate personal development, and empower nurses and student nurses to take more leadership in working according to EBP principles and improve healthcare delivery. CONCLUSION: Nurses experience difficulties applying EBP principles and need support with their implementation. Nurses' and student nurses' needs include obtaining more EBP knowledge and access to tailored and ready-to-use information. They also indicated the need for role models, autonomy, incentives, dedicated time, and incorporation of EBP in daily work practice.
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This case study presents a process that was iteratively developed for clinical informaticians to identify, analyse, and respond to safety events related to health information technologies (HIT) in community care settings (This research was supported by the CIHR Health Systems Impact Fellowship Program. We would also like to thank Vancouver Coastal Health for their valuable contributions.). The goal was to build capacity within a clinical informatics team to integrate patient safety into their work and to help them recognize and respond to HIT-related safety events. The technology-related safety event analysis process that was ultimately developed included three key components: 1) an internal workflow to analyse voluntarily reported HIT-related safety events using a sociotechnical model, 2) safety huddles to amplify learnings from reviewed events, and 3) a cumulative analysis of all events over time to identify and respond to patterns. A systematic approach to quickly identify and understand HIT safety concerns enables informatics teams to proactively reduce risks and prevent harm.
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Informática Médica , Seguridad del Paciente , Estudios de Casos Organizacionales , Humanos , Errores Médicos/prevención & control , Administración de la Seguridad , Servicios de Salud Comunitaria , Flujo de TrabajoRESUMEN
Care management of home-based long-term care is vital for community-dwelling older adults. Regarding care planning, which is a part of care management, appropriate care plans according to individual conditions are extremely important for older adults to continue living independently in their familiar environment for as long as possible. We compared the use of care services in the last year of life between advanced and conventional care management. The results showed that among the older adults with a care-need level of 3, 4, or 5, the advanced care management group had a significantly higher rate of use of home-visit nursing services than the conventional care management group. These differences could be attributed to differences in the care planning knowledge, experience, and the training environment of the care managers' offices.
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Servicios de Atención de Salud a Domicilio , Humanos , Anciano , Femenino , Masculino , Anciano de 80 o más Años , Cuidado Terminal , JapónRESUMEN
Objective: To compare the adequacy, agreement, and acceptability of Papanicolaou testing (cytology) for cervical cancer screening using self-collected samples compared to physician-collected samples in Grenada in the Caribbean. Furthermore, the study identifies the human papillomavirus (HPV) genotypes present among asymptomatic women testing positive for HPV, the etiologic cause of cervical cancer. Methods: Participants were divided into two groups and two cervical samples were collected from the women in each group: a self-collected sample and a physician-collected sample. Cervical specimens were tested for cytology and HPV. HPV genotyping was performed on positive specimens. Results: Self-collected samples were adequate and in agreement with physician-collected samples, showing no difference between the two sampling methods. Oncogenic high-risk HPV genotypes were identified in cervical samples which were positive for atypical squamous cells and low-grade squamous intraepithelial lesions. The high-risk HPV genotypes found, notably HPV 45 and 53, differed from those most commonly reported. Although the commonly reported high-risk genotypes HPV 16 and 18 were found, so were 31, 33, 35, 52, 66, 68, and 82. Conclusions: Using self-collection facilitated the discovery of unexpected HPV genotypes among asymptomatic women in Grenada. These findings add new information to the literature regarding cervical cancer and neoplasia screening and HPV genotypes in the Caribbean. This genotype information may impact surveillance of women with low-grade lesions, HPV vaccine selection, and possibly further vaccine research. Research regarding HPV in Caribbean pathology samples of cervical neoplasia and cancer is needed.
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OBJECTIVE: To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. STUDY DESIGN: Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. SETTING, PARTICIPANTS: Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. INTERVENTION: Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. MAIN OUTCOME MEASURES: Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. RESULTS: Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047). CONCLUSION: The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.
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Salud Mental , Adulto , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Emociones , Salud Mental/etnología , Prisioneros/psicología , Evaluación de Programas y Proyectos de Salud , Distrés Psicológico , Investigación Cualitativa , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Australia Occidental , Aborigenas Australianos e Isleños del Estrecho de TorresRESUMEN
The aim of this study was to explore community-working occupational therapists' involvement in research and development projects. A cross-sectional survey of occupational therapists working in community-based services in Norway (n = 617) was conducted. In all, 117 of the 617 participants responded that they were involved in research and development projects. Greater likelihood of participation in research and development work were found for occupational therapists who had completed further education. Current and prioritized research topics were professional development and the development of interprofessional and professional service designs for occupational therapy. Service and quality development, rehabilitation and technology were areas where more knowledge was considered needed. To increase the growth and success of occupational therapy research and development, it is important that more occupational therapists in the municipality continue to complete further education. High-quality occupational therapy practice should be based on research and development projects in the municipalities.
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Introduction: There is a growing presence of violence intervention workers who identify as women, yet their unique strengths and challenges have not been described previously. The purpose of this study was to characterize the intersections of gender and violence intervention work. Methods: We conducted a qualitative study of women working in violence intervention via focus groups. Perceived strengths and risks were explored using a semistructured interviewing technique. Focus groups were transcribed and coded by two separate evaluators. Grounded theory methodology was used for thematic analysis. Results: 17 violence intervention and outreach specialists who identify as women were included in three focus groups. Common challenges include a sense of powerlessness when faced with inequitable structural limitations and vicarious trauma. When discussing the role of their gender identity in the work, the women reported that men seem more willing to be emotionally vulnerable with women, including disclosures of a history of sexual abuse. Women also experience a lack of respect personally and professionally in their role related to gender. The women revealed a need for leadership opportunities to leverage their strengths and for enhanced training, especially for male colleagues who may benefit from the insights of colleagues who are women. Conclusions: Women bring unique strengths to roles as violence intervention specialists to deal with trauma and prevent future violence. These findings suggest a need for specific curricula to support women working in violence intervention and further studies that explore the intersectional role of race as well as gender in violence intervention work. Level of Evidence: 6.
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PURPOSE: Providing patient access to precision oncology (PO) is a major challenge of clinical oncologists. Here, we provide an easily transferable model from strategic management science to assess the outreach of a cancer center. METHODS: As members of the German WERA alliance, the cancer centers in Würzburg, Erlangen, Regensburg and Augsburg merged care data regarding their geographical impact. Specifically, we examined the provenance of patients from WERA´s molecular tumor boards (MTBs) between 2020 and 2022 (n = 2243). As second dimension, we added the provenance of patients receiving general cancer care by WERA. Clustering our catchment area along these two dimensions set up a four-quadrant matrix consisting of postal code areas with referrals towards WERA. These areas were re-identified on a map of the Federal State of Bavaria. RESULTS: The WERA matrix overlooked an active screening area of 821 postal code areas - representing about 50 % of Bavaria´s spatial expansion and more than six million inhabitants. The WERA matrix identified regions successfully connected to our outreach structures in terms of subsidiarity - with general cancer care mainly performed locally but PO performed in collaboration with WERA. We also detected postal code areas with a potential PO backlog - characterized by high levels of cancer care performed by WERA and low levels or no MTB representation. CONCLUSIONS: The WERA matrix provided a transparent portfolio of postal code areas, which helped assessing the geographical impact of our PO program. We believe that its intuitive principle can easily be transferred to other cancer centers.
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Accesibilidad a los Servicios de Salud , Oncología Médica , Neoplasias , Medicina de Precisión , Humanos , Alemania , Accesibilidad a los Servicios de Salud/organización & administración , Neoplasias/terapia , Oncología Médica/organización & administración , Instituciones Oncológicas/organización & administración , Población RuralRESUMEN
Background: The Chinese government proposes to establish a hierarchical diagnosis and treatment system, and attaches great importance to community health services. Under the background of population aging and the increase of older adults with disability, this study aimed to analyze the effect of spatial accessibility of community health services on the activities of daily living (ADL) among older adults in China. Methods: A research sample of 7,922 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018 was adopted. There were 2,806 participants in the treatment group and 5,116 participants in the control group. The propensity score matching method was adopted to match the treatment and control groups to calculate the values of average treatment effects on treated (ATT). Results: The results of kernel density matching method showed that the factual ADL score of the treatment group was 10.912, the counterfactual ADL score of the control group was 10.694, and the ATT value was 0.218 (p < 0.01). The spatial accessibility of community health services could significantly improve the activities of daily living among older adults in China. Meanwhile, there was urban-rural heterogeneity in the impact of spatial accessibility of community health services on the activities of daily living of older adults in China. The effect value in urban samples (ATT = 0.371, p < 0.01) was higher than that in rural samples (ATT = 0.180, p < 0.01). Conclusion: Spatial accessibility of community health services could improve the activities of daily living among older adults in China. The Chinese government should take actions to improve the distribution of community health service resources.
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Actividades Cotidianas , Servicios de Salud Comunitaria , Accesibilidad a los Servicios de Salud , Puntaje de Propensión , Humanos , China , Anciano , Masculino , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud Comunitaria/estadística & datos numéricos , Anciano de 80 o más Años , Estudios Longitudinales , Población Rural/estadística & datos numéricosRESUMEN
This research provides a critical narrative review of maternal and child health (MCH) in rural Japan, reflecting broader challenges faced by aging societies globally. The study explores the intertwined roles of professional and lay care in sustaining rural communities, emphasizing the unique position of family medicine and primary care in enhancing MCH services. The scarcity of healthcare resources, particularly the shortage of obstetricians and the weakening of traditional community support systems, underscores the challenges in these areas. Our review method involved a comprehensive search of PubMed for articles published from April 2000 to August 2024, focusing on MCH issues in rural Japan. This study highlights several critical gaps in rural MCH provision: the migration of medical professionals to urban centers, the transformation of social structures affecting traditional caregiving, and the lack of specialized MCH training among primary care physicians. We discuss potential solutions such as incentivizing obstetric care in rural areas, integrating MCH education within family medicine curricula, and revitalizing community-based support systems. By addressing these issues, the research aims to formulate actionable strategies to bolster MCH services, thus ensuring better health outcomes and sustainability of rural communities in Japan and similar settings worldwide.
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Introduction: The Health District (HD) is a critical component of Italy's National Health Service, responsible for ensuring Primary Health Care (PHC) services in response to community health needs. The Italian government established a national strategic reform program, the National Recovery and Resilience Plan (PNRR), starting in 2022, with a series of health interventions to reorganize the PHC setting, the main reform being the Ministerial Decree 77/2022 (DM77). Our study aimed to provide a description of socio-demographic data and to assess the correlation between HDs, in order to suggest health intervention priorities in PHC reforms. Materials and methods: We conducted our analysis using a cross-sectional record linkage of data from multiple sources to compare organizational and socio-demographic variables. A dataset was created with each of the 21 Italian Regions' HDs data of population, land area, mean age, ageing index, old-age dependency ratio, birth rate and death rate. The Inland Areas Project data was integrated for a socio-economic perspective. Results: Our study identified comparable groups of HDs, considering demographical, socio-economic and geographical aspects. The study provides a baseline understanding of the Italian situation prior to the implementation of DM77. It also highlights that inhabitants number cannot be the only variable to take into account for the definition of Italian HDs organisation and PHC reform, providing intercorrelated variables that take into account geographic location, demographic data, and socio-economic aspects. Conclusion: By acknowledging the interplay of demographic, socio-economic, and geographic factors, policymakers can tailor interventions to address diverse community needs, ensuring a more effective and equitable PHC system.
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Política de Salud , Atención Primaria de Salud , Italia , Humanos , Atención Primaria de Salud/organización & administración , Estudios Transversales , Factores Socioeconómicos , Reforma de la Atención de Salud , Anciano , DemografíaRESUMEN
Introduction: This study investigated the educational needs of integrated care among professionals in the public sector of healthcare and social care services in South Korea. Methods: A cross-sectional secondary data analysis was performed. Original data were obtained from 10 metropolitan communities with a convenience sample of 210 integrated care professionals. The Borich Needs Assessment Model and the Locus for Focus Model were used to examine the priority educational needs of each integrated care professional. Results: This study analyzed the key details of educational needs in integrated care by focusing on the competencies of integrated care approaches for person-centered care, interprofessional collaboration, and community involvement. The core educational needs of community care administrators, care coordinators, healthcare and social care providers, and community health champions, which are common to all professionals, and the specific educational needs for each type of professional were demonstrated, which contained specific content to implement integrated care. Conclusion: This study provides an opportunity to comprehensively understand the educational needs of integrated care professionals based on their competencies. They want better interprofessional cooperation through networking and collaborative strategies. The results of this study may be utilized as fundamental data by future instructors to provide evidence-based education programs.
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OBJECTIVES: This study aimed to assess the educational needs and analyze the priorities of infection prevention and control (IPC) for community-visiting nurses. DESIGN: This is a cross-sectional descriptive study. SAMPLE: This study was conducted with 144 visiting nurses working in public health centers and long-term care facilities in South Korea. METHOD: A total of 23 questions in five subcategories were used to measure the current knowledge and perceived importance of IPC in community-visiting nursing. Data were collected from June 23 to October 30, 2021, during the COVID-19 pandemic. Data were analyzed paired t-test, the Borich needs assessment, and the Locus for Focus models. RESULTS: Top-priority content was defined as content belonging to two models, the first 10 contents of Borich needs assessment and the contents located in the Quadrant I of the Locus for Focus models. "Reporting in case of infection-related accidents," "Mandatory vaccination for visiting nurses," "Standard precaution," "Airborne precaution," "Contact precautions," "Respiratory infection control," and "Post-visit management." CONCLUSIONS: This study suggests that it is necessary to provide visiting nurses with more opportunities for IPC education and to develop standardized IPC programs that consider educational priorities.